Provider Demographics
NPI:1528361821
Name:EHRENREICH, JUDY (OTR/L)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:EHRENREICH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ELM ST
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2611
Mailing Address - Country:US
Mailing Address - Phone:516-569-4402
Mailing Address - Fax:516-569-3710
Practice Address - Street 1:15 ELM ST
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-2611
Practice Address - Country:US
Practice Address - Phone:516-569-4402
Practice Address - Fax:516-569-3710
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012055-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist